Jeremy Burns

Individual provider Active NPI Physical Therapy Assistant · Essex, IA

NPI 1407233281 · NPPES record last updated Apr 30, 2015

Key facts

NPI
1407233281
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
077286 (IA)
Practice address
101 Victory St
Essex, IA 51638-3018
Phone
(409) 617-1844
NPI assigned
Apr 30, 2015
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
077286IAMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 077286 IA Yes

Addresses

Primary practice location

101 Victory St
Essex, IA 51638-3018

Mailing address

101 Victory St
Essex, IA 51638-3018

Other providers in Essex, IA

All providers in Essex, IA · Physical Therapy Assistant in Iowa

Sources for this page

Verify at the official NPI Registry.